Modify insurance policies, hold awareness drives: NHRC advisory for welfare of people with mental illness

New Delhi : Modification in insurance policies, restructuring of establishments as per contemporary requirements of technology and mass awareness campaigns are among a slew of recommendations that the NHRC made to the Centre and states for the welfare of people with mental illness.

The recommendations have been made in an advisory issued by the National Human Rights Commission (NHRC) on Tuesday coinciding with World Mental Health Day. "Mental health is the foundation for wellbeing and leads to a meaningful and productive life. In mental health institutions, emphasis is often placed on medication and therapy alone.

"Integrating mental health care into the community creates opportunities for individuals to engage with peers, participate in meaningful activities, and contribute to society," the NHRC said in its advisory. It said the Mental Healthcare Act, 2017, is a legislation to provide mental healthcare and services for people with mental illness and to protect, promote and fulfill the rights of such people during the delivery of mental healthcare and services and for matters connected therewith or incidental thereto.

The commission said it is "concerned about the implementation of the Mental Healthcare Act, 2017, on the ground". The NHRC said it is actively working to identify and address the lacunae and has issued this advisory containing a set of recommendations for the welfare and rights of persons with mental illnesses. "All states and Union Territories must prioritise constituting Mental Health Authority, Mental Health Review Boards and framing rules and regulations as mandated under sections 45, 73, 121 and 123 of the Mental Healthcare Act, 2017," the NHRC said.

Insurance policies and schemes should include treatment for mental illnesses to increase the accessibility and affordability of mental health care. To boost accessibility to treatments for mental disorders for financially disadvantaged populations, it is necessary to include mental illness in the 'Aayushman Bharat' scheme, the advisory said. Most establishments are "timeworn" and therefore it is necessary that they are "restructured as per the contemporary requirements of technology, amenities and services," the advisory read.

It stated that all fatalities on the premises of a hospital, institution, sheltered home, shared housing, rehabilitation home, halfway house and mercy house, must be reported to the police within 24 hours and to the NHRC within 48 hours. Establishments should not be used as cover-up institutions to delay the trial, the NHRC said. It added that establishments be maintained and enhanced in general amenities, including the number of beds, water, sanitation, food, bedding, clothing, and provision of recreational activities, among others.

Capabilities with special care for the geriatric population with mental illness be created in all establishments, it said. "Establishments need to consider increasing the number of family wards to provide better mental healthcare to the patients in proximity to their families, ensuring adequate support," it added. Other recommendations include creating "more PG in proportion to the requirements, including DPM, MD, DNB, MPhil, PhD in Psychiatry, Psychology, PSW, and DPN and other diplomas, degrees, fellowships, etc.

As mandated under Section 31(3) of the Act, 2017, efforts must be made to meet internationally accepted guidelines for a number of mental health professionals based on population by 2027". Psychiatry be included in the undergraduate medical curriculum as a separate subject. Every opportunity must be utilised to train doctors in basic psychiatry, a proper human resource plan may be developed and implemented by government agencies concerned, the advisory added. The NHRC has also recommended that efforts be made to raise awareness about yoga and educate people about mental health issues.

Yoga therapy should invariably be provided to patients, it said. 'Mental Health' may also be included as a subject matter to which Corporate Social Responsibility Funds may be given under Schedule VII (i) of the Companies Act, 2013, the commission said. Patients should not be retained in establishments even for a day after being declared fit for discharge, development of new abilities and involvement in occupational activities should be promoted in patients, it has also been recommended.